To identify margins of safety within which bronchoscopic Nd-YAG laser resection can be performed without damaging indwelling tracheobronchial stents.
In a world with finite natural resources and large energy demands, it is important to understand not just actual efficiencies, but also limits to efficiency, as the latter identify margins for efficiency improvement.
This strategy utilises blue light excitation (380 440 nm) to induce red fluorescent emissions (635 nm) from the tumour cells that concentrate PpIX, and has been put to practical use to identify margins of neoplasia during exploratory or tumour de-bulking surgery (Kriegmair et al, 1999; Holtl et al, 2001; Mayinger et al, 2001; Bogaards et al, 2005).
The researchers embarked on this project to better identify that margin.
Furthermore, it was difficult to identify the margin of this lesion exactly, because there is little difference in height between the flat part and surrounding normal mucosa, and magnifying IEE showed non-neoplastic images.
Touch-prep cytology has a sensitivity ranging from 75to100%0% and allows the entire margin to be surveyed but requires an on-site trained pathologist and can only detect tumor cells extending all the way up to the surgical margin; it is unable to identify close margins [ 9, 13, 14].
If MLL is identified, load margin, voltage stability, security margin can be determined and precaution can be taken.
These methods have limitations, however, including the requirement for an on-site trained pathologist, the inability to identify close margins (touch preparation cytology), and the ability to sample only a small portion of the margin (frozen section analyses) [ 12].
For surgeons performing open procedures, the sense of touch is a valuable tool to directly access buried structures and organs, to identify their margins, detect tumors, and prevent undesired cuts.
